"This book is terrifying, informative, stimulating, and educating to every member of the medical and nursing profession. It is extensively researched, has a massive bibliography, and, most importantly, it is well written and well worth reading — in spite of some truly
GPs allow patients to make harmful choices – thereby affording primacy to autonomy at the expense of beneficence – when that harm accrues only to the individual making such choices. But if your future self is a different person, does that mean
We often consider the malfunctioning of the health service to be someone else’s fault; the government's, the GPs', the receptionist's … but if we reflect on how our expectations, as a society, have changed over time, perhaps we might find ourselves complicit.
'When reading the spread of articles in this issue it struck me that we need diversity to be better clinicians, colleagues, and citizens.' Andrew Papanikitas reflects this month's Life and Times articles, discussing gender, diversity, narrative and queer bioethics.
In general practice we can discuss end of life and treatment escalations decisions with patients before they become very unwell, and this is where the ReSPECT process could potentially give a space for a meaningful patient-centred discussion about preferences at the end
In an attempt to improve physical health outcomes in this group, patients registered at their GP practice as having a severe metal illness are eligible to undergo an annual health check in a primary care setting. Richard Armitage discusses recent progress.
The recent release of “Queen Charlotte”, the Bridgerton spin-off series on Netflix, has reignited interest in the illness of King George III. Whilst the series is described as ‘fiction inspired by fact,’ the story of King George leads into the wider
Professor Joanne Reeve applies a new book on Mindlines and finds hope for UK primary healthcare
So what we need is the invention of a ‘new category’ of General Practitioner. David Mummery sets out his manifesto for the future general practitioner. Discussion welcome!
The wolves in the forest that frighten human beings are now at last being accurately named: poverty, homelessness, hunger, unemployment, domestic abuse, adverse childhood experiences. Humans like sheep have a basic need to feel safe. They can’t function well until that need
Hannah Barnes has written a detailed account of what happened at the Tavistock and Portman NHS Foundation Trust’s Gender Identity Development Service (GIDS). Margaret McCartney reflects on the risk that healthcare organisations run when worries from staff translate into organisational defensiveness.
A recent BBC Panorama ‘expose’ of private ADHD clinics suggests that some online providers are over-diagnosing ADHD following inadequate clinical assessments. Patients are increasingly turning to private providers both out of pocket and through right-to--choose arrangements, and ultimately, GPs may be asked
"I predict that, by June 2025, all GPs will be using some form of LLM-powered co-pilot in their day-to-day practice ... Used (and regulated) correctly, these tools will enhance patient care, improve GP working conditions, and relieve pressures on general practice in
"Morale in general practice has never been lower, and I can say that having been a GP for 37 years. In all this adversity and negative press, the care has carried on regardless, even allowing pockets of brilliance to shine through. We
Primary care systems can clearly be described as networks of people and things, ideas, processes, relationships and technologies. It is patently clear that we have a duty open the black boxes of our primary care systems, lest ignorance of how they work
What are the personal and human factors that most motivate and anchor our best healthcare? What best nourishes and sustains both patients and healthcarers to endure together life’s most difficult challenges? This book answers such questions with luminous and engaging clarity.
General practice can play a major role in assisting in raising awareness and supporting primary prevention, early identificationand intervention of domestic abuse, argues Vasumathy Sivarajasingam
This year marks the 75th anniversary of the foundation of the NHS, and it is timely to consider the post-1948 story of general practice, and what we can learn from the past to make the future more propitious than it appears. Edin
Fourteen years ago, I watched the drama-documentary-animation hybrid film: The Age of Stupid. This is set in a climate-ravaged 2055, and features a last-surviving human who has been entrusted to archive human records. He is reflecting on news footage demonstrating the devastation
Vasumathy Sivarajasingam showcases how GP practices in Ealing (NW London) worked towards ‘greener practice’ and sustainable healthcare.
Charlie Massey, Chief Executive of the GMC, tells us ‘there is no ready-made batch of GPs waiting to be plucked off the shelf to ease the pressures on the workforce...’ In the bookcase of doctors coming to the rescue of general practice,
Richard Armitage uses ChatGPT to interview an AI simulation of the 'Father of Western Medicine.'
In an era where difficulties in GP recruitment and retention are having significant impacts on the workforce, will knowing the ‘value’ of a GP give us any clues as to the projected cost in terms of loss to the system if that
Slight changes in phraseology can dramatically alter the central meaning of a vitally important principle. By “consenting the patient” instead of “seeking meaningful consent,” the right of our patients to be involved in choices about their treatment and care... is exchanged with
Andrew Papanikitas introduces the articles in this Month's Life and Times, and reflects on the meaning of 'Crisis' as it applies to global general practice
Rabia Aftab advocates that exercising these three Es (Expectations, explanation and empathy) in our consultations offers a path to better satisfaction for GP and patient alike.
"More validation should be given to the therapeutic benefits of listening closely and bearing witness to somebody’s suffering." – Rupal Shah and colleagues continue their hermeneutic series, focusing on the importance of relational care in general practice ...
The effects of the earthquakes on child health in Türkiye are substantial, multifaceted and, without urgent intervention, deeply enduring throughout the life course. Richard Armitage reports from the scene.
The independent contractor model for general practice is one of the under-rated aspects of the NHS that rarely hits the headlines. It is particularly important for our professional autonomy and business flexibility.
Teams are the talk of the town in practice transformation circles. They are extolled as the solution for many of our deficiencies– from chronic staffing shortfalls to employee burnout. This extended essay by David Loxterkamp gives a perspective from American primary care
My assumption was of a middle class journalist parachuting in to a deprived area and reporting through his own middle class lens. How wrong I was – this is actually the extraordinarily reflective work of a man who grew up with
When we use a computer scoring chart and tell a patient they have depression and need medication or even psychological therapy we locate the problem firmly in the brain of one individual. Does this prevent the wider solutions?
Crowdfunding of direct medical costs raises some ethical issues which may legitimately concern health professionals and should concern regulators. Kathryn Millard explores the key issues.
Sharing my humanity with your humanity, in snapshots, journeying together over a lifetime. That is the essence of the general practice that I know, love and hate simultaneously. Kathleen Wenaden reflects...
If there’s latent theme hiding in this month’s life and times, it has something to do with qualities and deployment of good leadership.
In the surgery, patients still express the hopelessness of their lived reality: lives built around sitting; exercise options that are difficult to access geographically and financially; and the cheapest food options too often the ‘wrong’ choices...
In the First and Second Ages, medicine was transacted between individual patients and doctors at times of illness. The Third Age, in which we find ourselves currently, is associated with the development of a much bigger picture in which this is no
"The conflict in Ukraine has displaced over 7 million people since February 2022. The UK Government has responded by issuing 219 400 visas for Ukrainians through sponsorship schemes. One year on, we feel there is value in reflecting on the health needs
"Who has been in charge of the processes of change in the last 20 years? What ingredients must be restored now that we have a full-blown factory farm model of primary care medicine? Is it too late to save family medicine 70
Foell and colleagues argue that assembly-line approaches in manufacturing rely on accurately measuring the time it takes to perform tasks in a digitalised workplace. They juxtapose this with the concept of time as the time it takes in the mystery of General
The worsening relationship between primary and secondary care if this NHS is to be saved, argues Edin Lakasing
